Vegetarians enjoy a 12 percent lower mortality rate than
meat eaters, according to a large observational study led by Michael J. Orlich,
MD, assistant professor of preventive medicine at Loma Linda University in
California. (JAMA Intern Med, July 8, 2013)

I'm often asked my opinion of the vegetarian diet. I
usually begin by saying that I don’t recommend extreme diets; they don’t
work over the long term. Few people are willing to stick with a diet they don’t
enjoy, especially one that bans their favorite foods. I then explain that I
consider myself a near vegetarian. My diet is built around, but not limited to,
vegetables, fruits, and whole grains. The new study suggests that I’m on the
right track.

They followed 73,308 participants in
the Adventist Health Study 2 for six years. The group included 48,203 women and
25,105 men; 8 percent were vegan, 10 percent pesco-vegetarian, 28 percent
lacto-ovo vegetarian, 6 percent semi-vegetarian, and 48 percent nonvegetarian.

As noted above, vegetarians as a group had 12 percent
lower death rate than nonvegetarians. The differences (adjusted as appropriate) within
the vegetarian groups were also noteworthy. The pesco-vegetarians fared best,
with a 19% lower mortality rate than the nonvegetarians. Vegans were next at 15%
lower, lacto-ovo 9%, and the semi-vegetarians last at 8% lower than
nonvegetarians.

Vegetarians also tended to be older, more educated and
most likely to be married, consumed less alcohol, smoked less, exercised more,
and were thinner. Associations in the men were larger and more often significant
than those in the women.

“These results demonstrate an overall association of
vegetarian dietary patterns with lower mortality compared with the nonvegetarian
dietary pattern,” the authors concluded. “They also demonstrate some
associations with lower mortality of the pesco-vegetarian, vegan, and
lacto-ovo-vegetarian diets specifically compared to the nonvegetarian diet.”

Commentary that accompanied the JAMA report made it clear
that healthy vegetarian eating is more complex than it might appear to a casual
observer.

There’s more to vegetarian eating than eliminating meat. A
junk food diet devoid of meat won’t make you healthy. Vegetables, fruits, and
grains should come mostly from whole foods; refined foods should be kept to a
minimum. Added sugars and sugary drinks should also be watched carefully.
Calorie control is, of course, always a consideration.

Meat should be replaced with foods containing complete
protein. Soybeans or beans combined with rice or other grains is an option if
you’re a vegan. Fish, eggs and low-fat dairy are options if your diet philosophy allows. If
you eat red meat occasionally it should be wild or grass fed—and not processed.
Meat from grain fed or partly grain fed animals contains more marbling and unhealthy
saturated fat.

Finally, vegans must be especially careful to get all the essential
nutrients. With careful meal planning it is quite possible to receive all the
nutrients required for a healthy life without meat or fish. But it’s not easy.
For example, protein, iron, zinc, and omega 3 fats must all be considered.

* * *

The Orlich study illustrates that there is a vegetarian
diet for almost everyone. As the researchers wrote in introducing the study,
“vegetarian diets represent common, real-world dietary patterns.” That probably
comes as a bit of a surprise to those who dismiss vegetarian diets as rabbit
food.

While the best vegetarian diet pattern is far from settled,
the key features of healthy vegetarian eating are clear. Lower saturated fat and
higher fiber consumption are generally recognized benefits of all vegetarian
diet patterns. On the flip side of the same coin, large studies have linked
increased red meat and processed meat consumption with higher mortality. Low
meat consumption is, of course, the hallmark of all vegetarian diets.

As mentioned earlier, I think of myself as a near
vegetarian. My diet doesn’t fit any of the vegetarian diet patterns in the
Orlich study. I take from all four vegetarian categories. Again, the bulk of my
diet comes from vegetables, fruits, and whole grains. I also eat nuts, fish,
eggs, and non-fat milk or yogurt on most days. Moreover, I have an occasional
burger made with bison or grass fed beef. Carol makes sure that our patties are
relatively small and the tomato and lettuce is thick. In addition to being a
delightful treat, these intermittent additions may provide a nutritional boost.

I believe mine is an intelligent approach to vegetarian
eating. I know that it is filling and satisfying. My taste buds are happy
campers.

I don’t ask you to eat like me, but I do suggest that you
consider it carefully. That’s also what Dr. Orlich and his colleagues ask you to
do with the favorable associations in their study. They are not cause and effect
findings, but they are consistent with many other observational studies.